The Division of Professional Licensure announced last week that 14 center clinicians entered into a consent agreement with the Board of Registration of Psychologists, admitting they "held themselves out as Psychologists and/or used the title 'Psychologist' without having a valid Massachusetts license," according to an agency press release.
The center has agreed to pay fines totaling $43,000 to resolve the allegations.
State Sen. Brian A. Joyce, D-Milton, who sponsored an unsuccessful amendment to ban aversive therapy in Massachusetts and intends to file it again in the Senate's next session, feels the settlement is just one symptom of a degenerative ailment of which the center is the cause.
"This is just the latest ugly chapter in a book filled with serious allegations regarding conditions at the Judge Rotenberg Center," Joyce said. "Over four deaths, unlicensed psychologists, reports that the background and preparation of the staff is simply not sufficient to oversee the treatment of children with serious emotional and behavioral problems, skin shocks used for relatively minor behaviors such as nagging and failing to keep a neat appearance, and the application of skin shocks to individuals while they bathed or showered - inconsistent with FDA regulations."
He's trying to get his fellow legislators on board in the battle to strip the center of its accreditation.
"How many more times will the Judge Rotenberg misrepresent important information before the Legislature takes notice?" Joyce asked. "States around the country have prohibited their students from coming to Massachusetts' [JREC], yet our own children have no such protection. What's going on is not only embarrassing, but it's also wrong."
A 19-year-old formerly violent, mentally retarded and autistic Taunton boy has been at the heart of the debate in the city's school system. At least two School Committee members are campaigning to stop the district's sponsorship of the boy's attendance at the center.
Committee member and Department of Social Services caseworker Alfred W. Baptista Jr. mentioned the "misrepresentation" of medical professionals at the center before a September committee meeting, where he voted against paying the $18,000 monthly bill.
Matthew Israel, Ph.D., the center's executive director, defended the center's employees. He said that since its founding in 1971, the center has employed clinical staff with training and graduate degrees (master's and doctorates) in psychology.
Those professionals provide diagnostic evaluations and develop and implement behavioral treatment plans, and the center assigned the job title "psychologist" to all of them, "even though not all of them had chosen to become licensed as psychologists by the Massachusetts Board of Registration," Israel said.
In 1996, the state amended a law to limit the use of the title to only those holding a state license.
"When, in May, [the center] first learned of this amendment, we immediately changed the title of those professional staff who were not holding a Massachusetts license to that of 'clinician,'" Israel said.
Israel challenges the new law's intent. He feels the center has been unjustly singled out because of its controversial methods.
"The intent of the 1996 amendment was no doubt to protect consumers from purchasing services from individuals who might hold themselves out to the public at large as 'psychologists' without having been sufficiently trained in the field," he explained. "But because the law did not change the substance of the work of the professional staff working within a specialty schools like ours, I believe that we and our professional staff were singled out because of a bias against aversive therapy, and not because of our mistake. Dozens of professionals employed at other schools made exactly the same honest mistake and to this day have not faced penalty."
State officials have, in turn, made details of the settlement very public, perhaps to send a message.
"Psychology is a state-licensed profession in Massachusetts," said George K. Weber, director of the Division of Professional Licensure. "Psychologist is not just a title that can be used at will. A licensed psychologist is an individual who has met the academic and clinical experience requirements of the board. Consumers have the right to expect that their psychologist has the proper credentials and is licensed to practice in the Commonwealth."
Leo V. Sarkissian, executive director of The Arc of Massachusetts - an activist group opposed to the center's Bay State operation - doesn't buy Israel's claims.
"The Arc of Massachusetts finds [his] arguments as to why its staff were practicing and testifying in a court of law without a license to be hollow and disturbing, given the sensitive nature of its procedures involving electrical shocks," he said. "Ignorance of the law is an old and tired defense, particularly when an organization [such as the center] has such substantial legal resources and the statute that was broken is 10 years old."
He stressed the vulnerable nature of those under care at Rotenberg facilities as the most important reason for scrupulously following licensing regulations.
"In this case, consumers are subjected to a highly controversial treatment involving pain," Sarkissian said. "One would assume those administrating such treatment would make every effort to comply with laws regarding the standards of staff engaged in the procedures. The fact that credentials of its staff were misrepresented runs contrary to the image [the center] seems so frequently to be in the habit of defending."
Dee Alpert, publisher of The Special Education Muckraker, a trade journal, has decided to play devil's advocate in the debate.
"I have researched the issue very, very carefully and - unfortunately - have been convinced by high-level behavior professionals that at this time, punishers such as electric shocks to the skin are the only effective mechanism for desperately required behavior modification for an extremely small number of persons with disabilities," Alpert said recently. "I find the whole issue of using pain as a behavior control abhorrent. Nevertheless, it appears that for a very, very few, pain is all that we know actually works at this time."
She has called for an independent review, by researchers unaffiliated with the center or state, to enter the facilities and collect objective data and put claims of shock therapy progress to the test.
Israel stands by the center's therapies, as well as the professionals working within its walls.
"Aversive therapy makes many people uncomfortable - and that is understandable," he said. "But the parents of children who cannot be successfully treated elsewhere know that it works, and it saves lives. Parents do not place their children at JREC because of the titles of our highly trained professionals; they place their children with us to address life-threatening behaviors that in many instances cannot be addressed elsewhere."
rschuler@tauntongazette.com